How to word this...

[LADoc00]

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I want to call some larger pathology groups and see if I can get crack at interpreting their FISH and Flow.

It would be a nice return on time investment for me and I could afford to kick back some of the $ to the practices that Im 100% sure arent doing their PC components on this (so is completely revenue positive for them).

But I how do approach them without coming across as too sketchy...or too predatory...or too condescendingly...

Ideas?

 

[coroner]

As long as you give off the vibe that you're not sniffing around to siphon business away from them and that both parties can potentially benefit, that should be good enough. I'm sure an introductory phone call to potential clients first asking what they are currently using for their Flow/FISH and then mention your quality/savings/turnaround time that you would potentially bring to the table would be a good start. Play up your commonalities that you are part of a small, independent practice that wants to look out for one another to prevent being swallowed up by the corporate megalabs. Better yet, schedule a face-to-face if you are in their vicinity as that would carry some weight vs whoever they're using that may be further away. If you think that may be too direct, then come up with some other excuse you want to get in touch with them and then casually transition into your sales pitch. From then on, assuming they are not enamored with their current provider of these services, it will just come down to dollars and cents. As you know there's no written agreements for length of service between groups and reference laboratories, it's just pay as you go. If it was me, kickback on PC would be enticing provided you are doing all the work. We were using Vantage Point for Flow & FISH while also charging our own PC for a "2nd opinion" for BM's when they were pretty much doing the bulk of the work. But, eventually the profit margin just wasn't worth the effort given our volume and we dropped our part/fee. Less money, but also less hassle...

 

[pathstudent]

It is hard to imagine a large group that doesn't already have guys that can interpret their own flow and fish, but if you know of some, go for it.

I expect the FISH market to crash jan 1 2015. CMS stealthy decided to only reimburse an 88367. 88368 per staining process this year and not per probe which effectively cuts the revenue by 1/2 in most cases and the code is expected to be "revalued" this fall further slashing reimbursement. Insurance companies will follow as it increases their profits and FISH will become a necessary and vital lab test which at best breaks even or loses money in some cases.

So make hay while the Sun shines.

 

[LADoc00]

It is hard to imagine a large group that doesn't already have guys that can interpret their own flow and fish, but if you know of some, go for it.

Not only do I know of several groups that dont interpret their own flow and almost none who do heme FISH, there are several groups with BC Hemepath people who dont do this...

Reason: If you are a hemepath person in a large 8+ man group, if you are stuck with doing all the flow and FISH and still take 1/8 share of the general surg path (and 1/8), then you are getting screwed so the motivation to step up and take this on is nil.

Pathology groups are run in such a crappy fashion they often dont along equity partners to earn different amounts based on service work...

And the number of people reading heme FISH in significant numbers (Im talking 100+ probes per week) is VANISHING small so I dont expect a change in 2015 via CMS (there is only 1 other group in all California doing this).

CMS will have enough of a headache with the Republican wave that creating Rep control of house+senate and the subsequent assaults on Obamacare...

I also dont plan business strategy around the mere threat of CMS cuts. If you did this, then you would never get out of bed in the morning.

 

[pathstudent]

Not only do I know of several groups that dont interpret their own flow and almost none who do heme FISH, there are several groups with BC Hemepath people who dont do this...

Reason: If you are a hemepath person in a large 8+ man group, if you are stuck with doing all the flow and FISH and still take 1/8 share of the general surg path (and 1/8), then you are getting screwed so the motivation to step up and take this on is nil.

Pathology groups are run in such a crappy fashion they often dont along equity partners to earn different amounts based on service work...

And the number of people reading heme FISH in significant numbers (Im talking 100+ probes per week) is VANISHING small so I dont expect a change in 2015 via CMS (there is only 1 other group in all California doing this).

CMS will have enough of a headache with the Republican wave that creating Rep control of house+senate and the subsequent assaults on Obamacare...

I also dont plan business strategy around the mere threat of CMS cuts. If you did this, then you would never get out of bed in the morning.

Like I advised, make hay while the sun shines. But don't be surprised if cms guts FISH reimbursement or makes them g codes in 2015. My people tell me they are next up on the chopping block.

 

[LADoc00]

FFS dude EVERYTHING is on the chopping blocks. Literally everything.

I had a eminent oncologist tell me at lunch today that the field of medical oncology was over. There would be no private heme/onc in the US within 5-10 years.

Youre on the deck of the Titanic yelling with a bullhorn that we are sinking, no crap bro, there are already thousands of bodies in the water and the sharks are circling...

I have a multi-tier strategy to get enough capital and pension to produce passive income within the next 4-5 years to simply not care, but yes you are totally f'd Pathstudent...Mikesheree save me a spot in the fishing boat bro!

 

[stickyshift]

Not only do I know of several groups that dont interpret their own flow and almost none who do heme FISH, there are several groups with BC Hemepath people who dont do this...

Reason: If you are a hemepath person in a large 8+ man group, if you are stuck with doing all the flow and FISH and still take 1/8 share of the general surg path (and 1/8), then you are getting screwed so the motivation to step up and take this on is nil.

Pathology groups are run in such a crappy fashion they often dont along equity partners to earn different amounts based on service work...

And the number of people reading heme FISH in significant numbers (Im talking 100+ probes per week) is VANISHING small so I dont expect a change in 2015 via CMS (there is only 1 other group in all California doing this).

CMS will have enough of a headache with the Republican wave that creating Rep control of house+senate and the subsequent assaults on Obamacare...

I also dont plan business strategy around the mere threat of CMS cuts. If you did this, then you would never get out of bed in the morning.

We used to have Neogenomics do the tech part of the FISH, but our pathologists would read the FISH and bill the PC on it.
Now we are the contracted pathology group for a large core laboratory, so we interpret our own flow and FISH--especially the Heme FISH. And with one exception, none of us are Hemepath BC.
And as LADOC pointed out, we have to be realistic about workloads: the guy doing all the flow and FISH should not be doing as much surgpath as the others. It's just common sense. As it is, our paths rotate the flow/FISH duties. Hell, some of us (myself included) interpret the FISH on our own bone marrow cases, regardless of who's on rotation.

 

[2121115]

Yes, this is all becoming more common. The way that everyone is making up the 88342 cuts is to bring PC FISH interpretation in house. These days I can't imagine any group with a hemepath boarded member not interpreting their own flow, and in a few years it will be the same for FISH, both heme and HER2 breast.

 

[pathstudent]

I'm not yelling that we are sinking. In fact we are setting ourselves up to have 2-3 great years by getting leaner. I'm just saying fish is going to get gutted next the way 88342 and 88305 were in the last two "re-evaluations".

I'll be yelling "the end is nigh" when cms announces bundled payments for professional services.

And frankly any large group that isn't t interpreting their own flow, fish, molecular anything that can be PC-TC split is a bunch of douche bags, so I wouldn't even offer to split the -26 with them as what do they care as they aren't getting the money anyway.

FFS dude EVERYTHING is on the chopping blocks. Literally everything.

I had a eminent oncologist tell me at lunch today that the field of medical oncology was over. There would be no private heme/onc in the US within 5-10 years.

Youre on the deck of the Titanic yelling with a bullhorn that we are sinking, no crap bro, there are already thousands of bodies in the water and the sharks are circling...

I have a multi-tier strategy to get enough capital and pension to produce passive income within the next 4-5 years to simply not care, but yes you are totally f'd Pathstudent...Mikesheree save me a spot in the fishing boat bro!

 

[deleted314957]

FFS dude EVERYTHING is on the chopping blocks. Literally everything.

I had a eminent oncologist tell me at lunch today that the field of medical oncology was over. There would be no private heme/onc in the US within 5-10 years.

Youre on the deck of the Titanic yelling with a bullhorn that we are sinking, no crap bro, there are already thousands of bodies in the water and the sharks are circling...

I have a multi-tier strategy to get enough capital and pension to produce passive income within the next 4-5 years to simply not care, but yes you are totally f'd Pathstudent...Mikesheree save me a spot in the fishing boat bro!

Not a problem as long as you like striped marlin and tuna in Cabo, dolphin in Islamorada and walleye in Canada!

 

[LADoc00]

And frankly any large group that isn't t interpreting their own flow, fish, molecular anything that can be PC-TC split is a bunch of douche bags, so I wouldn't even offer to split the -26 with them as what do they care as they aren't getting the money anyway.

Yah I rethought my strategy on this. You are right, any group that isnt doing every single damn thing right now to survive these crazy cuts doesnt deserve to be in business...So Im going to just "Raise the Black Flag and slit throats" instead.